Dino_Sore

Indeed. My recent PT was focused on restoring range of motion and strengthening muscles. Us old farts, especially if we are primarily cyclists, are full of muscle imbalances. Work with your therapist to understand what exactly they are prescribing and why. And be sure to walk away with exercises that you can continue with after the PT sessions are over. Good luck.

BlazingPedals

I don't expect that the cortisone shot will do much overall, but it may let you do the PT, and that MAY help.

Iride01 

Because your cycling only works your joints and a certain set of muscles to a very particular and repetitive range of motion and limit.

PT will probably involve doing stuff that you can't do on the bike. And that will give you better results when on the bike.

daniell

I tend to agree with you, but at least the pain has significantly lessened and I was able to stop taking the Aleve.

zacster

The first time I had a torn meniscus I got a cortisone shot and it was so effective I almost cancelled the surgery. The orthopedist guaranteed that the pain would return in time. I have recently torn it again and this time did not get the shot. The Dr this time said it would help but the tear was pretty big and I was having the surgery again anyway.

As for PT, I tried PT the second time before going back to the Dr, and while I could walk better the pain was still there. I'm back in PT and finding it is starting to help. And what was the thing PT recommended? Cycling of course. He said I should set up the trainer ASAP and get on and start easy. 50-75 watts max to start, low RPM. That'll be torture as that is so low as to not feel it, but that's the point. I'll work up to my old FTP of 200 maybe. I'm not so young anymore.

rsbob 

Just saw on the news last night an alternative to knee replacement which involves separating the knee joint by (I’m guessing here) about 1/4” so it is no longer bone on bone. The separation is achieved by screwing in an articulating brace connecting the femur and tibia. It was a quick story so didn’t get specifics but an interweb search could probably locate the technology.

daniell

If necessary, my next step will be gel shots.

DiabloScott

Those PT folks zeroed in on exactly what exersizes I needed to do, but they also listened to me about what I wanted to get done first (cycling). For my last visit I rode my bike there and hugged everybody.

oldbobcat

I'm treating a torn meniscus myself, from a fly-fishing incident. Physical therapy plus exercises plus shorter bike rides that avoid long or steep climbs are working. I'm being very careful not to mash. That is, if my cadence drops I concentrate on following the path of the cranks with my feet. And my out-of-saddle forays are short and careful.

Cortisone alleviates pain and inflammation, but it doesn't repair the joint, and if you're doing something to it that the cortisone masks, you're just making it worse.

davester

As a 68 year old, I have a torn meniscus (diagnosed about 5 years ago) and moderate to severe arthritis of the knees. At the time of my meniscus diagnosis I was having a lot of difficulty with knee locking, difficulty on stairs, impossible to run without pain, etc. I looked into surgery but for the typical meniscus trimming and cleaning out of the joint followed by physical therapy) the success rate (compared to physical therapy alone) was less than 50% and the downsides (long recovery, risks) were not great. Cortisone shots didn't do anything either. So, I embarked on a quest to find the best physical therapist. After going to and rejecting two (who just gave me generic handouts and exercises) I found one who really wanted to get to the bottom of what was happening with MY knees and developed customized exercises for me. She also said things like "how much are you willing to work on this to achieve the results you want", which motivated me to be much more involved in my own therapy. After a few months I was feeling much better and I can now hike, do trail runs, and bike with zero pain at all. No drugs either.

daniell

I am surprised that I got so much relief from the cortisone shot. I won't be surprised if it is only temporary. Tomorrow I start PT.

Classtime 

My wife has been vegan for almost 20 years which made it easy for me to gradually get to 97% vegan. I had knee pain beginning in my 30s (now 64). I continue to abuse my knees but they stopped hurting years ago. Two miniscus repairs and everything else but cortisone later and I truly believe that my diet has decreased the inflammation and relieved me of painful knees. It is not for everyone but it is free and there are no side effects.

daniell

At least the severe pain is gone and I am no longer taking Aleve. If that is all I can get, I will take it.

Sertsa

Hi. I sought out this thread, as I've been having knee issues. Mine seem somewhat tied to cold weather, too. Last winter my knees completely locked up, although thankfully at separate times. After doctor visits, x-rays, and shots, they improved to where I was reasonably mobile with Voltaren gel and an occasional ibuprofen. I also had a few weeks of physical therapy early in the year.

After temperatures warmed I did much better, not even needing the Voltaren and rarely ibuprofen, and I got back to almost daily rides. But in the last couple days, as temperatures have cooled, the knee pain in stiffness is starting again. It's mainly just discomfort at this point, but I'm concerned.

Anyway, does anyone else have cold-weather knee issues and have a way to manage it? It may not help that I live in the middle of a "snow belt."

wvridgerider

My time has come. Right knee to be replaced Nov 7, having it done with MAKO surgery. I have no miniscus left. The left knee will follow. The surgeon told me that people in my condition dont walk in to his office. After a 24 hour mtb race 20+ years ago I had two miniscule tears in my right knee and they said there isnt much left. I got all I could out of it, cortisone treatment for the last year. Went to ride yesterday and had issues so my year may be over.

Classtime 

Well, WV, you’ll be back at it soon enough. A guy in our group was again stronger faster than me 6 weeks after his.

daniell

Best of luck with your surgery, and I hope that you will be back on the bike before long.

Dino_Sore

I ride year-round here in Connecticut and sometimes experience stiffness and soreness in my knees in the winter. Last year I put on knee warmers under my winter tights and that seemed to help.

chaadster

n my experience— both personally and with friends— when you’ve got arthritis and a meniscus tear, one can spend, or I could say waste, a lot of time trying to figure out a solution. As we see in this thread, there are a variety of treatments and courses of action available which simply take time to work through if you want to try them. The big question is, in my opinion, how much time to do you want to spend trying to figure it out, probably in pain, probably unable to ride, versus how much do you want to avoid— and this may be a controversial way to phrase it— the sure-shot of knee replacement. Both approaches take time, for sure, but one path has time spent experimenting, while the other is time spent recuperating.

I’ve had two surgeries on my right knee for cartilage damage and meniscus tear over the past 11 years or so, and have been struggling with arthritis pain the whole time. Much of it probably stems from a compound fracture of the tib/fib I sustained in a bad cycling accident 27 years ago, but regardless, the issues are arthritis and cartilage damage. A very good sports-specific orthopaedic surgeon here, with a substantial list of high-performing collegiate and pro athletes, one of whom referred me to him, told me 11 years ago that knee replacement was going to be the ultimate solution for me, but given I wasn’t yet 50, we decided the best approach was to fix the cartilage damage arthroscopically and kick the arthritis can down the road until my life quality was bad enough that replacement made sense.

I’m 52 now, and went through some dark periods for several years where the constant pain made me grouchy, embarrassed by my difficulty walking and limp, and kept me from consistent cycling training. I had to go from off the front to off the back, quite literally. I gained weight and lost a lot of fitness, both of which have been hard to get back with my busy, mid-life schedule (work, teen kids, etc.). Many times I’d wished I’d done the replacement and gotten it out of the way so that I could have enjoyed those years rather than suffer them.

Though my left knee also got in on the arthritis game sometime during that time span— with swelling, pain— by some miracle, when I quit working during COVID, in ‘20, things got a lot better, probably because my activity level (i.e. time on feet) went way down and my knees were able to heal, adapt, or something like that, because the pain lessened a lot. I started training reliably in spring ‘21, and have ridden well since then and am able to walk around fairly well, too, so I can vacation with the family without spoiling the good time exploring new places. It’s pretty ok now, but arthritis is degenerative, so it’s really like a ticking timebomb, right?

Had COVID not happened, had I not quit work for a year and 8 months, would have taken the path I did? Probably not; I think I would have gotten the replacement because a) it was that bad, and b) quality of life is very important to me because of my family.

Oh, one other thing which may be helpful to those managing arthritis pain, is marijuana cream. I have a grower friend who makes me a liniment from her bud trimmings, and it has been an absolute godsend for me, allowing me to be on my feet most of the day without pain. It’s also great for me at night, so I can sleep without pain. It’s full-test stuff, in the sense it’s got both THC and CBD; I’d tried a commercial CBD cream previously to no effect, but I dunno if it’s the quality or other ingredients, or the THC, but if you can, I’d try the most complete, un-futzed with stuff you can get.

Best wishes on good resolution to the OP.

wvridgerider

Thats promising. I too dont do eshifting, tubeless on the road but enjoy tying bead headed nymphs.

daniell

What's next?
I had my cortisone shot and I am doing the PT. I had a couple of good weeks. Did a few 20 mile rides. Now the pain is returning.

Carbonfiberboy 

The idea that your current provider says they'd do a TKR but not a meniscus snip still bothers me, the snip being vastly less expensive. What's that about? Your insurance? Maybe check with them to see if that's the case. They'd cover one but not the other? If that's not the case, try a different osteopath who's also covered by your insurance. This doesn't sound right at all. Another idea is that it's time to renew insurance for next year. If it's an insurance problem, shop around and see if another insurer would cover the snip, which you could then get after Jan. 1.

daniell

The doctor that I am now seeing does not do surgery. He would recommend a surgeon. He said that my pain is more from the arthritis.

Carbonfiberboy 

I've have had more less-than-competent doctors than I've had good ones. I'd get an opinion from an osteopath. Biology is insanely complicated. It's amazing what a few hundred million years of competitive survival can produce.

StarBiker

Mother had both knees done 10 years ago. Work out once in a while in a gym, but no cycling. She would not have been able to walk without knee replacement. Before modern knee replacement surgery (The replacements last longer, about 30 years) folks like my mother spent their remaining years in a wheelchair.....

She is the only person in the family that needed knee surgery. (Just about everybody was dead by the age of 60, overweight, smoked, and/or stressed)

Hopefully the OP and others have made out ok.

I get minor left knee pain in colder weather, but changing bikes recently made a huge difference.

Oddly since the weather has changed I have not gone any real distance.